Case Presentation: A 32 year-old female without significant medical history presented with nausea and vomiting, 1 week after being a pedestrian struck by a vehicle. The original accident caused loss of consciousness, and post-concussive syndrome headaches, but no significant injuries, fractures or internal bleeding. Upon re-admission, she was orthostatic positive. She was lethargic, with a [...]

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As an outpatient, right heart catheterization revealed a pulmonary arterial pressure (PAP) of 76/24 mmHg, mean PAP of 41 mmHg, wedge [...]

Case Presentation: A 34 year-old female without medical history who had an uncomplicated vaginal delivery 3 months prior presented with acute onset right upper quadrant abdominal pain and several episodes of emesis. The patient took no prescription medications; however, she had been taking fenugreek for the past 6-8 weeks to enhance her milk production in [...]

Case Presentation: A 46 year-old man with decompensated cirrhosis (MELD 45) presented with dizziness and confusion for two days. He denied any other new symptoms. Home medications included lactulose, propranolol, pantoprazole, folic acid and thiamine. On arrival, the patient was normothermic (99.2 F), with bradycardia to 30-40 BPM and blood pressures of 80s/40s mmHg. He [...]

Case Presentation: A 27-year-old man with no known medical history was brought in by his family for progressive personality change and worsening insomnia. Three months prior to presentation, the patient had begun skipping coursework for his PhD program, and was noted to have new outbursts of unprovoked anger and impulsivity. On presentation, he was oddly [...]

Case Presentation: A 29-year-old Asian male with a one-year history of recurrent generalized muscle weakness presented to the emergency department with whole body paralysis. The patient’s symptoms began abruptly that morning, when he was unable to stand and exit a train due to lower extremity weakness, which generalized over the course of one hour. He [...]

Case Presentation: 81 year old male with medical history of Abdominal Aortic aneurysm(AAA) ,COPD on home oxygen, diverticulitis post colon resection 10 years ago presented to the emergency department with painless hematochezia for 4 days. CT abdomen showed an interval increase in size of his AAA to 6 cm diameter and 8 cm in length [...]

Case Presentation: A 79-year-old male with metastatic prostate cancer status post multiple systemic agents presented with recurrent episodes of epistaxis with associated anemia and fatigue. The patient had a pertinent history of multifactorial CKD stage III. He was diagnosed with a left nasal polyp which required polypectomy. Despite removal of the polyp, the patient continued [...]

Case Presentation: A 39-year old female with a history of alcohol abuse presented with an eight-day history of numbness involving her bilateral lower extremities and hands which had progressed proximally to involve her chest wall. She reported perioral and perianal numbness, lethargy and difficulty ambulating. Examination was significant for decreased sensation in a glove-stocking distribution, [...]

Case Presentation: A 51-year-old woman presented with recurrent confusion and altered mental status over the past 6 months. She reported associated hallucinations, altered sleep cycle and hyper-arousal symptoms. She was treated with lactulose and rifaximin for suspected hepatic encephalopathy with no improvement. She denied any other symptoms. Past medical history was significant for cirrhosis secondary [...]